Nevada tied with Colorado, Georgia, Hawaii and New Jersey for next-lowest in their ability to respond. Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored highest.

The report says that in the years since Sept. 11, 2001, preparedness has improved.

But it points to gaps in readiness for health and extreme weather emergencies, bioterrorist threats and serious disease outbreaks. Trust executive Jeffrey Levi calls the report a snapshot of the nation's public health emergency preparedness.

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